Tests at the breast cancer clinic

If you have suspected breast cancer, either because of your symptoms or because your mammogram has shown an abnormality, you'll be referred to a specialist breast cancer clinic for further tests.

Mammogram and breast ultrasound

If you have symptoms and have been referred to a specialist breast unit by your GP, you'll probably be invited to have a mammogram, which is an X-ray of your breasts. You may also need an ultrasound scan.

If your cancer was detected through the NHS Breast Screening Programme, you may need another mammogram or ultrasound scan.

Your doctor may suggest that you only have a breast ultrasound scan if you're under the age of 35. This is because younger women have denser breasts, which means a mammogram isn't as effective as ultrasound in detecting cancer.

Ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts, showing any lumps or abnormalities.

Your breast specialist may also suggest a breast ultrasound if they need to know whether a lump in your breast is solid or contains liquid.

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Stage and grade of breast cancer

Stage of breast cancer

When your breast cancer is diagnosed, the doctors will give it a stage. The stage describes the size of the cancer and how far it has spread, and helps to predict the outlook.

Ductal carcinoma in situ (DCIS) is sometimes described as stage 0. Other stages of breast cancer describe invasive breast cancer:

stage is – the tumour is "in situ" and there's no evidence of invasion (pre-invasive)

stage 1 – the tumour measures less than 2cm and the lymph nodes in the armpit aren't affected; there are no signs that the cancer has spread elsewhere in the body

stage 2 – the tumour measures 2-5cm, the lymph nodes in the armpit are affected, or both; there are no signs that the cancer has spread elsewhere in the body

stage 3 – the tumour measures 2-5cm and may be attached to structures in the breast, such as skin or surrounding tissues, and the lymph nodes in the armpit are affected; there are no signs that the cancer has spread elsewhere in the body

stage 4 – the tumour is of any size and the cancer has spread to other parts of the body (metastasis)

This is a simplified guide. Each stage is divided into further categories: A, B and C. If you're not sure what stage you have, ask your doctor.

TNM staging system

The TNM staging system may also be used to describe breast cancer, as it can provide accurate information about the diagnosis:

T – the size of the tumour

N – whether the cancer has spread to the lymph nodes

M – whether the cancer has spread to other parts of the body

Grade of breast cancer

The grade describes the appearance of the cancer cells.

low grade (G1) – the cells, although abnormal, appear to be growing slowly

medium grade (G2) – the cells look more abnormal than low-grade cells

high grade (G3) – the cells look even more abnormal and are more likely to grow quickly